DMZHP is an abbreviation for the defect of the interventricular septum in the fetus, that is, the congenital defect of this organ.
DMF for the fetus - causes
There are 2 main causes of congenital heart disease:
- Heredity . Various congenital heart defects or other organs that are transmitted by inheritance and not only from parents to the child. The risk of CHD , including DMF for the fetus, is also when heart defects have been encountered in previous generations, with close relatives or in other families with this family.
- Disturbance of heart development in the fetus . It occurs due to any teratogenic factors affecting the fetus during embryonic development: infection, intoxications of various etiologies, adverse environmental effects.
Sometimes both of these causes are combined.
Types of VSD in the fetus
The interventricular septum is divided into three parts according to its structure: the upper membrane, the middle muscular and the trabecular lower part. Depending on the part of the defect, the VSW are divided into:
- Defects of the membranous part, or darital - under the aortic valve and pulmonary artery, can be closed independently at small sizes);
- peremembranous VSD in a fetus is a combined defect that is in the muscle tissue, but one of the edges is formed by the connective tissue of the membranous part of the septum;
- defect in the muscular part - are far from the valves in the muscle tissue;
- complete absence of septum;
- peregrevevyy DMZHP - above the supraventricular ridge.
To size:
- Large - the diameter of the defect is greater than the diameter of the aorta and the pressure in both ventricles is equal;
- mean - defect is less than the diameter of the aorta and pressure in the right ventricle is 50% of the pressure in the left;
- small - when the defect is so small that the pressure in the right ventricle increases by no more than 25%, often occurs asymptomatically.
All VSD should be detected at the second screening ultrasound at 20 weeks , since with a combination of VS with other heart defects that are incompatible with life, a woman may be recommended to interrupt pregnancy. And with isolated VSD with proper management of childbirth and treatment in the postpartum period 80% of children have a chance to survive.
DMF for the fetus - treatment
With VSW, pressure builds up in the small circle of circulation, and the time for which the operation is to be performed depends directly on the size of the defect.
Treatment VSD operative. If the defect of the septum is large, the operation should be performed in the first 3 months after childbirth. With moderate defects and a buildup of pressure in a small circle of blood circulation, the child is operated up to 6 months after birth, with an average with a slight increase in pressure in the right ventricle and small defects - up to a year. Some small defects in this period are closed by themselves.